Diagnosis and classification of blepharospasm: Recommendations based on empirical evidence.

Blepharospasm / diagnosis Cross-Sectional Studies Dystonia / diagnosis Dystonic Disorders / diagnosis Humans
Blepharospasm Craniofacial dystonia Meige syndrome

Journal

Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403

Informations de publication

Date de publication:
15 08 2022
Historique:
received: 21 02 2022
revised: 18 05 2022
accepted: 06 06 2022
pubmed: 19 6 2022
medline: 5 8 2022
entrez: 18 6 2022
Statut: ppublish

Résumé

Blepharospasm is one of the most common subtypes of dystonia, and often spreads to other body regions. Despite published guidelines, the approach to diagnosis and classification of affected body regions varies among clinicians. To delineate the clinical features used by movement disorder specialists in the diagnosis and classification of blepharospasm according to body regions affected, and to develop recommendations for a more consistent approach. Cross-sectional data for subjects diagnosed with all types of isolated dystonia were acquired from the Dystonia Coalition, an international, multicenter collaborative research network. Data were evaluated to determine how examinations recorded by movement disorder specialists were used to classify blepharospasm as focal, segmental, or multifocal. Among all 3222 participants with isolated dystonia, 210 (6.5%) had a diagnosis of focal blepharospasm. Among these 210 participants, 34 (16.2%) had dystonia outside of upper face region. Factors such as dystonia severity across different body regions and number of body regions affected influenced the classification of blepharospasm as focal, segmental, or multifocal. Although focal blepharospasm is the second most common type of dystonia, a high percentage of individuals given this diagnosis had dystonia outside of the eye/upper face region. These findings are not consistent with existing guidelines for the diagnosis and classification of focal blepharospasm, and point to the need for more specific guidelines for more consistent application of existing recommendations for diagnosis and classification.

Sections du résumé

BACKGROUND
Blepharospasm is one of the most common subtypes of dystonia, and often spreads to other body regions. Despite published guidelines, the approach to diagnosis and classification of affected body regions varies among clinicians.
OBJECTIVE
To delineate the clinical features used by movement disorder specialists in the diagnosis and classification of blepharospasm according to body regions affected, and to develop recommendations for a more consistent approach.
METHODS
Cross-sectional data for subjects diagnosed with all types of isolated dystonia were acquired from the Dystonia Coalition, an international, multicenter collaborative research network. Data were evaluated to determine how examinations recorded by movement disorder specialists were used to classify blepharospasm as focal, segmental, or multifocal.
RESULTS
Among all 3222 participants with isolated dystonia, 210 (6.5%) had a diagnosis of focal blepharospasm. Among these 210 participants, 34 (16.2%) had dystonia outside of upper face region. Factors such as dystonia severity across different body regions and number of body regions affected influenced the classification of blepharospasm as focal, segmental, or multifocal.
CONCLUSIONS
Although focal blepharospasm is the second most common type of dystonia, a high percentage of individuals given this diagnosis had dystonia outside of the eye/upper face region. These findings are not consistent with existing guidelines for the diagnosis and classification of focal blepharospasm, and point to the need for more specific guidelines for more consistent application of existing recommendations for diagnosis and classification.

Identifiants

DOI: 10.1016/j.jns.2022.120319 PMID: 35716653 PMC: PMC9357089
pubmed: 35716653
pii: S0022-510X(22)00181-2
doi: 10.1016/j.jns.2022.120319
pmc: PMC9357089
mid: NIHMS1817488
pii:
doi:

Types de publication

Journal Article Multicenter Study Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

120319

Subventions

Organisme : NINDS NIH HHS
ID : U54 NS116025
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS075321
Pays : United States
Organisme : NCATS NIH HHS
ID : U54 TR001456
Pays : United States
Organisme : NINDS NIH HHS
ID : U54 NS065701
Pays : United States
Organisme : NINDS NIH HHS
ID : R01 NS119831
Pays : United States

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

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Auteurs

Gamze Kilic-Berkmen (G)

Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA.

Giovanni Defazio (G)

Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.

Mark Hallett (M)

Human Motor Control Section, National Institute of Neurological Disorders and Stroke, National Institute of Health, Bethesda, MD, USA.

Alfredo Berardelli (A)

Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077 Pozzilli, Italy.

Gina Ferrazzano (G)

Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy.

Daniele Belvisi (D)

Department of Human Neuroscience, Sapienza University of Rome, Viale dell'Università 30, 00185 Rome, Italy; IRCCS NEUROMED, Via Atinense 18, 86077 Pozzilli, Italy.

Christine Klein (C)

Institute of Neurogenetics and Department of Neurology, University of Luebeck, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany.

Tobias Bäumer (T)

Institute of System Motor Science, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.

Anne Weissbach (A)

Institute of Neurogenetics and Department of Neurology, University of Luebeck, University Hospital of Schleswig-Holstein, Campus Luebeck, Luebeck, Germany; Institute of System Motor Science, University of Lübeck, Ratzeburger Allee 160, Lübeck, Germany.

Joel S Perlmutter (JS)

Department of Neurology, Radiology, Neuroscience, Physical Therapy and Occupational Therapy, Washington University School of Medicine, St Louis, MO, USA.

Jeanne Feuerstein (J)

Department of Neurology, University of Colorado, Aurora, CO, USA.

H A Jinnah (HA)

Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA. Electronic address: hjinnah@emory.edu.

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Classifications MeSH

questionsmedicales.fr › Maladies de l'oeil › Maladies de la paupière › Blépharospasme › Diagnosis and classification of blepharospasm:...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études transversales › Diagnosis and classification of blepharospasm:...
questionsmedicales.fr › États, signes et symptômes pathologiques › Signes et symptômes › Manifestations neurologiques › Dyskinésies › Dystonie › Diagnosis and classification of blepharospasm:...
questionsmedicales.fr › Maladies du système nerveux › Maladies du système nerveux central › Troubles de la motricité › Troubles dystoniques › Diagnosis and classification of blepharospasm:...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Diagnosis and classification of blepharospasm:...